Ancient foe, serious weapon: Subarachnoid hemorrhage secondary to TB meningitis

Mohammed Omer Khalil Ali; Ahmed E Elhassan; Mohamed S Elgara; Mohamed Abdelhady; Hamad Abdel Hadi

doi:10.1016/j.idcr.2020.e00941

Ancient foe, serious weapon: Subarachnoid hemorrhage secondary to TB meningitis

IDCases. 2020 Sep 8:22:e00941. doi: 10.1016/j.idcr.2020.e00941. eCollection 2020.

Authors

Mohammed Omer Khalil Ali¹, Ahmed E Elhassan², Mohamed S Elgara¹, Mohamed Abdelhady³, Hamad Abdel Hadi⁴

Affiliations

¹ Department of Internal Medicine, Hamad Medical Corporation, Qatar.
² Faculty of Medicine, University of Khartoum, Sudan.
³ Neuroradiology Section, Department of Neurosciences, Hamad Medical Corporation, Doha, Qatar.
⁴ Department of Infectious Diseases, Communicable Diseases Centre, Hamad Medical Corporation, Qatar.

Abstract

Tuberculosis is an ancient infectious disease with global distribution and a multitude of multisystem presentations. Infection of the central nervous system (CNS) is the most serious presentation manifested as tuberculous meningitis (TBM), intracranial tuberculoma, and tuberculous arachnoiditis all associated with significant morbidity and mortality. TBM is the commonest form of CNS manifestations capable of causing secondary arteritis leading to vascular complications. We report a case of a 22-year-old Indian patient diagnosed with TBM who subsequently presented with sudden onset severe headache, which was eventually diagnosed as subarachnoid hemorrhage. Radiological assessment confirmed secondary complications with cerebral aneurysmal dilatation attributed to TBM. The patient was safely managed with combined radiological and surgical interventions with uneventful outcomes. Review of the literature revealed that such complication of TBM is rare usually with serious implications. We aim to highlight to infection specialists to be aware of such association.

Keywords: Aneurysm; Subarachnoid hemorrhage; TB; Tuberculous meningitis; Vasculitis.

Publication types

Case Reports